Cardiovascular safety of sublingual apomorphine in patients on stable doses of oral antihypertensive agents and nitrates
| Autor: | Timothy C. Fagan, Addison A. Taylor, Anthony Edmonds, Thomas Marbury, Susan M. Buttler |
|---|---|
| Rok vydání: | 2001 |
| Předmět: |
Adult
Male medicine.medical_specialty Apomorphine medicine.drug_class Adrenergic beta-Antagonists Administration Sublingual Angiotensin-Converting Enzyme Inhibitors Calcium channel blocker Placebo Sublingual administration Orthostatic vital signs Double-Blind Method Erectile Dysfunction Heart Rate Internal medicine Heart rate medicine Humans Diuretics Adrenergic alpha-Antagonists Antihypertensive Agents Aged Aged 80 and over Analysis of Variance Cross-Over Studies Nitrates business.industry Middle Aged Calcium Channel Blockers Crossover study Blood pressure Treatment Outcome Anesthesia Dopamine Agonists Hypertension Cardiology Electrocardiography Ambulatory Cardiology and Cardiovascular Medicine business medicine.drug |
| Zdroj: | The American journal of cardiology. 88(7) |
| ISSN: | 0002-9149 |
| Popis: | Sublingual (SL) apomorphine (2 to 6 mg) has been shown to be effective for treatment of male erectile dysfunction. Many patients with erectile dysfunction are also being treated for systemic hypertension and/or cardiovascular disease. In a double-blind, randomized, placebo-controlled, crossover trial, SL apomorphine 5 mg and placebo were administered on alternate days to 162 men who were on long-term therapy (or =4 weeks) with angiotensin-converting enzyme inhibitors, beta blockers, diuretics, calcium channel blockers, alpha(1) blockers, or short- or long-acting nitrates. Blood pressure and heart rate were measured before and after dosing; cardiac rhythm was recorded by 4-hour Holter monitoring. The only potentially clinically significant interactions between SL apomorphine and the antihypertensive agents or short-acting nitrates were greater orthostatic decreases in systolic blood pressure in the alpha-blocker and calcium channel blocker groups (-10 and -6 mm Hg vs placebo, respectively). Administration of SL apomorphine after dosing with long-acting nitrates resulted in significant decreases in blood pressure when patients were standing (mean systolic change, -5 to -9 mm Hg 30 to 60 minutes postdose, p0.05; mean diastolic change, -3 to -4 mm Hg 50 to 60 minutes postdose, p0.05). The most common adverse events with SL apomorphine were dizziness, nausea, and headache. Syncope occurred in 1 patient in the beta-blocker group; symptomatic hypotension occurred in 2 patients each in the short- and long-acting nitrate groups. Thus, in patients receiving common antihypertensive agents and short-acting nitrates, as well as in most patients receiving long-acting nitrates, SL apomorphine at higher than recommended doses produced no clinically significant changes in heart rate or blood pressure greater than changes seen with SL apomorphine alone. |
| Databáze: | OpenAIRE |
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